Digital pulley enlargement allowing early active motion following primary repair of flexor tendons.

We present a new technique of pulley enlargement that preserves its continuity without suturing. The principle of this technique is to excise 2 opposite symmetric triangles. For each of these triangles, the incision starts in the middle of the edge of the pulley and ends beyond the middle of its length. The pulley is enlarged over its entire length, both by debridement of the extremities and by plastic deformation. Although this technique precludes complete closure of the digital sheath, it spares the continuity of the pulley and thus allows early active rehabilitation.